[unreadable] [unreadable] Despite the availability of vaccines against influenza and pertussis, infants less than 6 months of age are not eligible to be vaccinated against influenza, are too young to be completely vaccinated against pertussis and therefore remain vulnerable to pertussis and influenza. Both pertussis and influenza in very young infants have significant morbidity (primarily hospitalization) and at times death. Studies have shown that an adolescent or adult contact is often the source of these two respiratory pathogens for infants and children. Because of this, it is postulated that one of the best means of protecting these infants is to vaccinate the household contacts, especially the birth mother. Accordingly, the Advisory Committee on Immunization Practices recommends that persons who have close contact with young infants receive influenza vaccine as well as combined tetanus toxoid, diphtheria toxoid and reduced dose acellular pertussis vaccine (Tdap). However, data reveal that only 13 percent of mothers of newborns report receiving influenza vaccine and limited data for uptake of Tdap in birth mothers [unreadable] are available. Strategies to improve vaccine delivery of Tdap and influenza to household contacts of newborns, especially birth mothers, are needed. The primary aim of this project is to develop and implement a hospital-based strategy of vaccinating birth mothers with Tdap year round and influenza vaccine during influenza season (October to March) using a standing order. In addition, this project seeks to define barriers and to develop and implement strategies to vaccinate household contacts of newborn infants with Tdap (year-round) and influenza during the influenza season. The proposal seeks to implement a standing order for vaccination of birth mothers during hospitalization at a community hospital,including documenting the processes, evaluating the barriers encountered and strategies with the most success, and comparing the overall vaccination uptake (effectiveness of these strategies) with a control community hospital. Methods developed, coupled with educational materials, will then form a tool-kit that will be shared with other hospitals nationally for implementation. This proposal also seeks to explore an expanding role of the hospital-based pharmacists in providing vaccines to household contacts. In addition, the proposal will consider the cost-benefit of a standing order related to the predicted prevention of morbidity and mortality in young infants due to pertussis and influenza. [unreadable] [unreadable] [unreadable]